Client Forms

If you’re a new client, please complete the following Intake Form as well as the Disclosure Statement and Consent for Services form.  You may fill them out directly on this page or if you prefer, download and print out the pdf versions then bring them to your first therapy session.

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), please also complete the Authorization to Disclose Information Form.

Please also CLICK HERE to read our Notice of Privacy Practices

Choose a Form:

If you prefer to download and print this form, click the following button:

DOWNLOAD PDF

Authorization to Disclose Information Form

All fields are required.  If something does not pertain to you, please put n/a in the field